How Kellogg worked with ‘independent experts’ to tout cereal

"The company paid the experts an average of $13,000 a year, prohibited them from offering media services for products 'competitive or negative to cereal' and required them to engage in 'nutrition influencer outreach' on social media or with colleagues, and report back on their efforts."

Nannystate: Food and drink should be banned from cinemas

A word from the editor: Food and drink should be banned from cinemas

Do I find the need to keep digging my paw into a packet of crisps or slavering my way through a plate of cheese to help my grey cells along? No, I don’t. Quite apart from the noise, smell and disruption involved in this wilfully antisocial behaviour there is also the sense that everyone around the eater is being quietly, insidiously insulted.

Angela N. Bartley, Mary Kay Washington, Christina B. Ventura, Nofisat Ismaila, Carol Colasacco, Al B. Benson III, Alfredo Carrato, Margaret L. Gulley, Dhanpat Jain, Sanjay Kakar, Helen J. Mackay, Catherine Streutker, Laura Tang, Megan Troxell, and Jaffer A. Ajani (2016) HER2 Testing and Clinical Decision Making in Gastroesophageal Adenocarcinoma: Guideline From the College of American Pathologists, American Society for Clinical Pathology, and American Society of Clinical Oncology. Archives of Pathology & Laboratory Medicine In-Press.

Early Online Release

HER2 Testing and Clinical Decision Making in Gastroesophageal Adenocarcinoma: Guideline From the College of American Pathologists, American Society for Clinical Pathology, and American Society of Clinical Oncology

Angela N. Bartley , MD; Mary Kay Washington , MD, PhD; Christina B. Ventura , MT(ASCP); Nofisat Ismaila , MD; Carol Colasacco , MLIS, SCT(ASCP); Al B. Benson III , MD; Alfredo Carrato , MD, PhD; Margaret L. Gulley , MD; Dhanpat Jain , MD; Sanjay Kakar , MD; Helen J. Mackay , MBChB, MD; Catherine Streutker , MD; Laura Tang , MD, PhD; Megan Troxell , MD, PhD; Jaffer A. Ajani , MD

From the Department of Pathology, St. Joseph Mercy Hospital, Ann Arbor, Michigan (Dr Bartley); the Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Washington); Surveys (Ms Ventura) and Governance (Ms Colasacco), College of American Pathologists, Northfield, Illinois; Quality and Guidelines Department, American Society of Clinical Oncology, Alexandria, Virginia (Dr Ismaila); the Division of Hematology/Oncology, Northwestern University, Chicago, Illinois (Dr Benson); Medical Oncology Department, Ramon y Cajal University Hospital, Madrid, Spain (Dr Carrato); the Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill (Dr Gulley); the Department of Pathology, Yale University School of Medicine, New Haven, Connecticut (Dr Jain); the Department of Pathology and Laboratory Medicine, UCSF, San Francisco, California (Dr Kakar); the Division of Medical Oncology and Hematology, University of Toronto/Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada (Dr Mackay); the Department of Laboratory Medicine, St. Michael's Hospital, Toronto, Ontario, Canada (Dr Streutker); the Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York (Dr Tang); the Department of Pathology, Stanford University Medical Center, Stanford, California (Dr Troxell); and the Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston (Dr Ajani).

Reprints: Angela N. Bartley, MD, Department of Pathology, St. Joseph Mercy Hospital, 5603 E Huron River Dr, Ann Arbor, MI 48108 (email: angelbart16@gmail.com).

Context.—ERBB2 (erb-b2 receptor tyrosine kinase 2 or HER2) is currently the only biomarker established for selection of a specific therapy for patients with advanced gastroesophageal adenocarcinoma (GEA). However, there are no comprehensive guidelines for the assessment of HER2 in patients with GEA.

Objectives.—To establish an evidence-based guideline for HER2 testing in patients with GEA, to formalize the algorithms for methods to improve the accuracy of HER2 testing while addressing which patients and tumor specimens are appropriate, and to provide guidance on clinical decision making.

Design.—The College of American Pathologists, American Society for Clinical Pathology, and American Society of Clinical Oncology convened an expert panel to conduct a systematic review of the literature to develop an evidence-based guideline with recommendations for optimal HER2 testing in patients with GEA.

Results.—The panel is proposing 11 recommendations with strong agreement from the open-comment participants.

Recommendations.—The panel recommends that tumor specimen(s) from all patients with advanced GEA, who are candidates for HER2-targeted therapy, should be assessed for HER2 status before the initiation of HER2-targeted therapy. Clinicians should offer combination chemotherapy and a HER2-targeted agent as initial therapy for all patients with HER2-positive advanced GEA. For pathologists, guidance is provided for morphologic selection of neoplastic tissue, testing algorithms, scoring methods, interpretation and reporting of results, and laboratory quality assurance.

Conclusions.—This guideline provides specific recommendations for assessment of HER2 in patients with advanced GEA while addressing pertinent technical issues and clinical implications of the results.

“Obesity can no longer be considered a lifestyle disorder and according to WHO, it is now considered a disease."

Bengaluru Anti-Obesity Day: Check stress, watch your diet

DECCAN CHRONICLE. | JOYEETA CHAKRAVORTY

“Obesity can no longer be considered a lifestyle disorder and according to WHO, it is now considered a disease. Also, obesity cannot be pinned on overeating or inadequate exercise.” stresses Dr Sumit Talwar, Chairman, Bariatric Surgery, Manipal hospital.

Lung cancer cells spread like unanchored tents, study says

"Writing in the Journal of Clinical Investigation, researchers from York and the University of Texas describe how the communications centre of a cell - known as the Golgi apparatus - receives a signal from proteins which prompts the movement of membrane sacks inside it.

This movement alters the shape and surface of the cancer cell, allowing it to break free from its moorings and move around freely."

"The beauty of great works of literature can lie in part in the way they take very specific individual experiences and, somehow, speak to the universal human condition. But the idea that this understanding comes simply from suffering is rarely true."

The literary glamour of madness

EMILY REYNOLDS

"Ask anyone with mental health problems to characterize their illness and they’re likely to describe the void of depression as boring, not inspiring, and the frantic, manic despair that many people experience as more disabling than it is galvanizing. This can be particularly true for those with bipolar disorder, which Jamison and others consider to be the “ultimate” in artistic illnesses –  but the shuttle between despair, shame and ennui can move so rapidly that taking a shower can sometimes seem ambitious, let alone writing your magnum opus.

The beauty of great works of literature can lie in part in the way they take very specific individual experiences and, somehow, speak to the universal human condition. But the idea that this understanding comes simply from suffering is rarely true."

"Due to its deep position, most pancreatic tumours are hard to locate. It is one of the reasons why the cancer isn’t detected until it advances and starts producing symptoms."

Where is the tumour?

Dr Prasad Narayanan Nov 26, 2016

Pancreas is a vital part of our digestive system and performs two functions. It secretes enzymes that aid digestion (exocrine function) and regulates blood glucose level by secreting the hormones insulin and glucagon (endocrine function). 

The organ is anatomically broken down into the head, body and tail. The widest part of the pancreas, the head, is located near the stomach and the duodenum, towards the centre of your abdomen. The tail of the pancreas is thinner and is to the left of the abdomen. Due to its deep position, most pancreatic tumours are hard to locate. It is one of the reasons why the cancer isn’t detected until it advances and starts producing symptoms. 

"The number of hospital beds in England taken up by patients being treated for malnutrition has almost trebled over the last 10 years, in what charities say shows the 'genuinely shocking' extent of hunger and poor diet."

Huge rise in hospital beds in England taken up by people with malnutrition

Critics blame three-fold rise on poverty, cutbacks to meals on wheels services for the elderly and inadequate social care

"The number of hospital beds in England taken up by patients being treated for malnutrition has almost trebled over the last 10 years, in what charities say shows the “genuinely shocking” extent of hunger and poor diet.

Official figures reveal that people with malnutrition accounted for 184,528 hospital bed days last year, a huge rise on 65,048 in 2006-07. The sharp increase is adding to the pressures on hospitals, which are already struggling with record levels of overcrowding."

I am running for a second term as Governor, College of American Pathologists Board of Governors. My vision is here.

I am running for a second term as Governor, College of American Pathologists Board of Governors.  My vision is here.

"As you admire your Thanksgiving feast spread, here are five traditional foods that bureaucrats want to take off the menu..."

What Regulators Want Off Your Thanksgiving Table

By The Foundation for Economic Education on November 23, 2016 1:42 pm

"As you admire your Thanksgiving feast spread, here are five traditional foods that bureaucrats want to take off the menu..."

Orthopedics. 2016 Nov 22:1-6. doi: 10.3928/01477447-20161116-03. [Epub ahead of print]

Surgical Cost Disclosure May Reduce Operating Room Expenditures.

Austin LS, Tjoumakaris FP, Ong AC, Lombardi NJ, Wowkanech CD, Mehnert MJ.

Abstract

Health care expenditures are rising in the United States. Recent policy changes are attempting to reduce spending through the development of value-based payment systems that rely heavily on cost transparency. This study was conducted to investigate whether cost disclosure influences surgeons to reduce operating room expenditures. Beginning in 2012, surgeon scorecards were distributed at a regional health care system. The scorecard reported the actual direct supply cost per case for a specific procedure and compared each surgeon's data with those of other surgeons in the same subspecialty. Rotator cuff repair was chosen for analysis. Actual direct supply cost per case was calculated quarterly and collected over a 2-year period. Surgeons were given a questionnaire to determine their interest in the scorecard. Actual direct supply cost per rotator cuff repair procedure decreased by $269 during the study period. A strong correlation (R2=0.77) between introduction of the scorecards and cost containment was observed. During the study period, a total of $39,831 was saved. Of the surgeons who were queried, 89% were interested in the scorecard and 56% altered their practice as a result. Disclosure of surgical costs may be an effective way to control operating room spending. The findings suggest that providing physicians with knowledge about their surgical charges can alter per-case expenditures. 

Hastings Cent Rep. 2016 Nov;46(6):14-24. doi: 10.1002/hast.644.

What Pacemakers Can Teach Us about the Ethics of Maintaining Artificial Organs.

Hutchison K, Sparrow R.

Abstract

One day soon it may be possible to replace a failing heart, liver, or kidney with a long-lasting mechanical replacement or perhaps even with a 3-D printed version based on the patient's own tissue. Such artificial organs could make transplant waiting lists and immunosuppression a thing of the past. Supposing that this happens, what will the ongoing care of people with these implants involve? In particular, how will the need to maintain the functioning of artificial organs over an extended period affect patients and their doctors and the responsibilities of those who manufacture such devices? Drawing on lessons from the history of the cardiac pacemaker, this article offers an initial survey of the ethical issues posed by the need to maintain and service artificial organs. We briefly outline the nature and history of cardiac pacemakers, with a particular focus on the need for technical support, maintenance, and replacement of these devices. Drawing on the existing medical literature and on our conversations and correspondence with cardiologists, regulators, and manufacturers, we describe five sources of ethical issues associated with pacemaker maintenance: the location of the devices inside the human body, such that maintenance generates surgical risks; the complexity of the devices, which increases the risk of harms to patients as well as introducing potential injustices in access to treatment; the role of software-particularly software that can be remotely accessed-in the functioning of the devices, which generates privacy and security issues; the impact of continual development and improvement of the device; and the influence of commercial interests in the context of a medical device market in which there are several competing products. Finally, we offer some initial suggestions as to how these questions should be answered.

"...what the Soviet Union represented most was not geopolitical but moral superiority. This may seem a strange way to describe a state that imprisoned and executed millions of its own citizens."

Love and Death in Revolution Square

Vadim Nikitin  Fall 2016

Secondhand Time: The Last of the Soviets
by Svetlana Alexievich, translated by Bela Shayevich
Fitzcarraldo Editions, 2016, 704 pp.

However, as Alexievich shows in Secondhand Time, for many of its former citizens—often derided as sovoks, a cruel pun on the word for dustpan—what the Soviet Union represented most was not geopolitical but moral superiority. This may seem a strange way to describe a state that imprisoned and executed millions of its own citizens. But as one woman reminds Alexievich, “socialism isn’t just labour camps, informants, and the Iron Curtain, it’s also a bright, just world: everything is shared, the weak are pitied, and compassion rules. Instead of grabbing everything you can, you feel for others.”

Arch Pathol Lab Med. 2016 Nov 7. [Epub ahead of print]

Diagnosis of Acute Cellular Rejection and Antibody-Mediated Rejection on Lung Transplant Biopsies: A Perspective From Members of the Pulmonary Pathology Society.

Roden AC1, Aisner DL, Allen TC, Aubry MC, Barrios RJ, Beasley MB, Cagle PT, Capelozzi VL, Dacic S, Ge Y, Hariri LP, Lantuejoul S, Miller RA, Mino-Kenudson M, Moreira AL, Raparia K, Rekhtman N, Sholl L, Smith ML, Tsao MS, Vivero M, Yatabe Y, Yi ES.

Author information

• 1From the Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Rochester, Minnesota (Drs Roden, Aubry, and Yi); the Department of Pathology, University of Colorado, Denver (Dr Aisner); the Department of Pathology, University of Texas Medical Branch, Galveston (Dr Allen); the Department of Pathology and Genomic Medicine, Methodist Hospital, Houston, Texas (Drs Barrios, Cagle, Ge, and Miller); the Department of Pathology, Mount Sinai Health System, Icahn School of Medicine, New York, New York (Dr Beasley); the Department of Pathology, University of São Paolo, Brazil (Dr Capelozzi); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Dacic); the Department of Pathology, Massachusetts General Hospital, and Harvard Medical School, Boston (Drs Hariri and Mino-Kenudson); Département de Biopathologie, Centre Léon Bérard, Lyon, Université Joseph Fourier INSERM U 823, Institut A. Bonniot, La Tronche, France (Dr Lantuejoul); the Department of Pathology, New York University Langone Medical Center, New York, New York (Dr Moreira); the Department of Pathology, Northwestern University, Chicago, Illinois (Dr Raparia); the Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York (Dr Rekhtman); the Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (Drs Sholl and Vivero); the Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Scottsdale (Dr Smith); the Department of Pathology, University Health Network/Princess Margaret Cancer Centre and University of Toronto, Toronto, Ontario, Canada (Dr Tsao); and the Department of Pathology and Molecular Diagnostics, Aichi Cancer Center, Nagoya, Japan (Dr Yatabe).

Abstract

CONTEXT:

- The diagnosis and grading of acute cellular and antibody-mediated rejection (AMR) in lung allograft biopsies is important because rejection can lead to acute graft dysfunction and/or failure and may contribute to chronic graft failure. While acute cellular rejection is well defined histologically, no reproducible specific features of AMR are currently identified. Therefore, a combination of clinical features, serology, histopathology, and immunologic findings is suggested for the diagnosis of AMR.

OBJECTIVE:

- To describe the perspective of members of the Pulmonary Pathology Society (PPS) on the workup of lung allograft transbronchial biopsy and the diagnosis of acute cellular rejection and AMR in lung transplant.

DATA SOURCES:

- Reports by the International Society for Heart and Lung Transplantation (ISHLT), experience of members of PPS who routinely review lung allograft biopsies, and search of literature database (PubMed).

CONCLUSIONS:

- Acute cellular rejection should be assessed and graded according to the 2007 working formulation of the ISHLT. As currently no specific features are known for AMR in lung allografts, the triple test (clinical allograft dysfunction, donor-specific antibodies, pathologic findings) should be used for its diagnosis. C4d staining might be performed when morphologic, clinical, and/or serologic features suggestive of AMR are identified.

"White Americans without a college degree are becoming more likely to die in middle age, reversing decades of progress toward better health."

Economists says changing U.S. economy may have been fatal to some Americans

• By Max Ehrenfreund • Washington Pos

"White Americans without a college degree are becoming more likely to die in middle age, reversing decades of progress toward better health.

Researchers first noticed this worrisome trend last year. They pointed to increases in opioid abuse, obesity and suicide among the causes of death, but what caused these increases has remained something of a mystery.

This week, a pair of economists have advanced a new theory. They suggest that, for many workers, a major shift in the structure of the U.S. economy could have been fatal.

The researchers, Justin Pierce and Peter Schott, found evidence that trade with China has resulted in greater rates of suicide and poisonings (including fatal drug overdoses) after 2000, when President Clinton and Republican lawmakers allowed a major increase in imports.

Pierce and Schott suggest that as competition with Chinese manufacturing forced U.S. factories to close, many of the Americans who were laid off never got their lives back together. Instead, they fell into depression or addiction. White adults, in particular, suffered from the change in policy."

FDA Delays Lab Test Changes Until Trump Takes Office

FDA Delays Lab Test Changes Until Trump Takes Office

By Michael D. Williamson

"Nov. 18 — The FDA said it won’t be regulating laboratory-developed tests anytime soon, a decision that elicited praise from the lab industry and Republican lawmakers Nov. 18.

The FDA will wait until the next presidential administration to move forward with its plan to oversee such tests, the agency said in a statement. The agency was expected to issue final policies on the lab developed tests, known as LDTs, by the end of this year.

Lab test makers, such as Laboratory Corporation of America and Quest Diagnostics, stand to benefit from the delay."

J Pediatr. 2016 Nov 9. pii: S0022-3476(16)31086-1. doi: 10.1016/j.jpeds.2016.10.018. [Epub ahead of print]

Parental Attitudes About Placebo Use in Children.

Faria V1, Kossowsky J2, Petkov MP3, Kaptchuk TJ4, Kirsch I4, Lebel A3, Borsook D3.

Author information

• 1Center for Pain and the Brain, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Psychology, Uppsala University, Uppsala, Sweden; Program in Placebo Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Electronic address: vanda.rochafaria@childrens.harvard.edu.
• 2Program in Placebo Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Clinical Psychology and Psychotherapy, University of Basel, Basel, Switzerland.
• 3Center for Pain and the Brain, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA.
• 4Program in Placebo Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

Abstract

OBJECTIVE:

To assess parental attitudes regarding placebo use in pediatric randomized controlled trials and clinical care.

STUDY DESIGN:

Parents with children under age 18 years living in the US completed and submitted an online survey between September and November 2014.

RESULTS:

Among all 1300 participants, 1000 (76.9%; 538 mothers and 462 fathers) met the study inclusion criteria. The majority of surveyed parents considered the use of placebos acceptable in some pediatric care situations (86%) and some pediatric trials (91.5%), whereas only 5.7% of parents found the use of placebos in children always unacceptable. The clinical use of placebo was considered acceptable by a majority of parents for only 7 (mostly psychological) of the 17 conditions presented. Respondents' judgment about acceptability was influenced by the doctors' opinions about the therapeutic benefits of placebo treatment, the conditions for pediatric placebo use, transparency, safety, and purity of placebos.

CONCLUSION:

Most surveyed parents accepted the idea of using placebos in pediatric trials and within the clinic for some conditions without the practice of deception and with the creation of guidelines for ethical and safe use. This study suggests a need to reconsider pediatric trial design and clinical therapy in the light of generally positive parental support of appropriate placebo use.

"...Brussels bureaucrats increasingly subject chemicals to the guillotine of fact-challenged, agenda-driven science."

The U.S. Can't Ignore Europe's Unscientific Regulations

By Dr. Joseph Perrone
November 19, 2016

"America's economy is increasingly intertwined with the European Union's, and unfortunately the litany of bad European imports hasn't ended with Russell Brand. Today, Brussels bureaucrats increasingly subject chemicals to the guillotine of fact-challenged, agenda-driven science. And while we have yet to see how Trump will execute his campaign pledges on trade, one thing is certain: the United States can no longer ignore Europe’s proposed unscientific restrictions of safe and economically important substances used in countless everyday products."

"Swedish culture has taken a step further lately, by making moves towards a six-hour working day."

Working less to live well: Work-obsessed Americans should take a cue from Swedes

Over-worked people cost companies time and money, because they increase need for health care and time off

"Swedish culture has taken a step further lately, by making moves towards a six-hour working day. In many of the organizations and companies that have made the change, they’ve noticed that their staff are happier, more productive and more creative, which proves the point that if the employees feel better, they’ll actually do better work. It’s a win-win situation.

Burned-out people cost companies and society time and money. They need healthcare, time off work, replacements have to be recruited and trained. Rested, enthusiastic staff members feel positive about their workplaces and can be passionate about their jobs."

Tackling the problem of childhood obesity

"Just how big is the problem of childhood obesity?

On the global front, over 42 million under-five-year-olds are overweight/obese.

In Malaysia, one in four children/adolescents are overweight, and we are at the top of the list (in the region) for childhood obesity at 30%."

Read more at http://www.star2.com/family/children/2016/11/20/tackling-the-problem-of-childhood-obesity/#chG0UCPIJFYXsl3C.99

Sarcopenia is "to muscles what osteoporosis is to bones"

Sarcopenia: New disease affects thousands

There's a "new" disease on the block and its name is Sarcopenia - a muscle-wasting condition that affects one in three Australians over the age of 60.

The loss of muscle mass as we age is normal. Usually people aged 30 and over lose about four to five per cent every year.

But for some. they lose much more, affecting their function and quality of life.

Australia's leading expert on the condition and musculoskeletal research, Professor Gustavo Duque from the University of Melbourne, says Sarcopenia is excessive muscle loss associated with poor muscle function.

It is "to muscles what osteoporosis is to bones" yet doctors are often "ignorant" of the condition that has major implications for thousands of older Australians, according to Prof Duque.Sarcopenia: New disease affects thousands

Obesity can increase risk of blood cancer, says new study

Obesity can increase risk of blood cancer, says new study 


"The study, by a team at Washington University School of Medicine in St. Louis, found that being overweight or obese has been known to increase the risk of multiple myeloma, a cancer of the plasma cells in the blood and bone marrow that develops more often after age 60."

Read more at:
http://economictimes.indiatimes.com/articleshow/55511267.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst

From U Chicago: Social media as a tool for antimicrobial stewardship

Am J Infect Control. 2016 Nov 1;44(11):1231-1236. doi: 10.1016/j.ajic.2016.07.005.

Social media as a tool for antimicrobial stewardship.

Pisano J1, Pettit N2, Bartlett A3, Bhagat P2, Han Z2, Liao C4, Landon E5.

Author information

• 1Department of Medicine, Section of Infectious Diseases and Global Health, University of Chicago Medicine, Chicago, IL. Electronic address: jpisano@medicine.bsd.uchicago.edu.
• 2Department of Pharmacy, University of Chicago Medicine, Chicago, IL.
• 3Department of Pediatrics, Section of Infectious Diseases and Global Health, University of Chicago Medicine, Chicago, IL.
• 4Department of Public Health Sciences, University of Chicago, Chicago, IL.
• 5Department of Medicine, Section of Infectious Diseases and Global Health, University of Chicago Medicine, Chicago, IL.

Abstract

BACKGROUND:

To increase the reach of our antimicrobial stewardship program (ASP), social media platforms, Facebook and Twitter, were used to increase internal medicine residents' (IMRs') antibiotic (Abx) knowledge and awareness of ASP resources.

METHODS:

Fifty-five of 110 (50%) IMRs consented to participate; 39 (71%) completed both pre- and postintervention surveys and followed our ASP on social media. Along with 20 basic Abx and infectious diseases (IDs) questions, this survey assessed IMR awareness of ASP initiatives, social media usage, and attitudes and beliefs surrounding Abx resistance. Over 6 months, IMRs received posts and Tweets of basic Abx/IDs trivia while promoting use of educational tools and clinical pathways on our ASP Web site. To compare pre- and postsurvey responses, McNemar test or Stuart-Maxwell test was used for categorical variables, and paired t test or Wilcoxon signed-rank test was used for continuous variables, as appropriate.

RESULTS:

Of the IMRs, 98% and 58% use Facebook and Twitter, respectively. To compare pre- and postintervention, median scores for Abx knowledge increased from 12 (interquartile range, 8-13) to 13 (interquartile range, 11-15; P = .048); IMRs knowing how to access the ASP Web site increased from 70% to 94%. More IMRs indicated that they used the clinical pathways "sometimes, frequently, or always" after the intervention (33% vs 61%, P = .004).

CONCLUSIONS:

Social media is a valuable tool to reinforce ASP initiatives while encouraging the use of ASP resources to promote antimicrobial mindfulness.

Rep. Price clear favorite for Trump's HHS chief

By JENNIFER HABERKORN

 

11/18/16 03:55 PM EST

"Price, a physician and an ardent opponent of Obamacare, would lead the dismantling of the Affordable Care Act and potentially help Congress enact a new health plan. His selection would be a strong embrace of the House's effort to repeal and replace Obamacare."

Despite decrease in rate, Virginia ranks first in childhood obesity

"The data shows Virginia is making progress. The decline in childhood obesity rates began in 2010 when the rate was at a peak of 21.5 percent.

In 2012, the rate dropped by 1 percent to 20.5 percent. It then showed another decrease in 2014 dropping to 20 percent.

Despite the improvement, Virginia ranks number one in the U.S. for the highest childhood obesity rate among 2-4 year olds enrolled in WIC, which is well above the national average of 14.5 percent."

On euthenasia: All My Ethics Live in Texas

Ann Thorac Surg. 2016 Dec;102(6):1786-1787. doi: 10.1016/j.athoracsur.2016.09.087.

All My Ethics Live in Texas.

Goodrich G1.

Author information

• 1The Krause Center for Leadership and Ethics, The Citadel, 171 Moultrie St, Charleston, SC29409. Electronic address: ggoodric@citadel.edu.

"This case illustrates how important it is for clinics, in places where euthanasia is legal, to have clear procedures regarding the involvement of visiting physicians whose primary place of employment is located where euthanasia is illegal. Such clinics should consider how their requests could affect the lives and careers of their visiting physicians."

Crystal Moore: A Pathologist’s Insights: Learning from Gwen Ifill

A Pathologist’s Insights: Learning from Gwen Ifill

Crystal Moore, MD, PhD, FCAPCrystal Moore, MD, PhD, FCAP, achieved her dual doctorate, physician-scientist degree at the Medical College of Virginia; she completed her residency training in Anatomic and Clinical Pathology at Duke University and is a board-certified Fellow of the College of American Pathologists.

"The first female African-American host of a major political TV show and role model to women around the world, Gwen Ifill, passed away from endometrial carcinoma. The illness and death of the award-winning journalist gives women a reason to pause and consider the importance of awareness to identify cancers that are prevalent but, with early detection, have high survival rates."

HT:MM

Kids who drink whole-fat milk are healthier than those who drink low-fat

by Chuck Bednar

Children who consume more whole milk tend to be leaner and have higher vitamin D levels than those who regularly drink low-fat or skim milk, a team of Canadian pediatricians claimed in new research published online Wednesday by the American Journal of Clinical Nutrition.

According to CBC and AFP News reports, lead author Dr. Jonathon Maguire, a pediatrician at St. Michael's Hospital in Toronto, and his colleagues recruited nearly 2,800 children between the ages of two and six and monitored their height, weight, and body-mass index (BMI) levels.

Read more at http://www.redorbit.com/news/health/1113416544/whole-milk-low-fat-milk-111816/#mzOZ1fUjO2i4WfPJ.99

"Swift believed that humans have an innate capacity for reason, which they fail to use."

The irrational rationality of Jonathan Swift

Swift believed that humans have an innate capacity for reason, which they fail to use. But did he take the human comedy too seriously?

"Swift as Stubbs presents him was essen­tially double-minded: rigidly authoritarian in his commitment to prevailing institutions, especially the Anglican Church, and at the same time recklessly daring in stripping these institutions of any pretension to seriousness; supposedly a pious believer, yet one who could write that religion taught us how to hate but not how to love; a conservative who valued order over justice, but who put an impassioned condemnation of slavery into the mouth of the narrator in Gulliver’s Travels and defended Ireland, for whose people he had little if any affection, against English power. In his literary life he was a serial hoaxer, and in his most fantastical writings an author who prized truth over imagination; an inveterate joker, affectionately known to his closest female companions as “Presto”, who in later life was never known to laugh." 

Surgeon General Report: 'Addiction Is Not a Character Flaw'

Addiction is a chronic illness, not a character flaw or a moral failing, the report says. Stigma and shame have kept people from seeking help and weakened public investment.

Murthy issues a call to action in the preface: "How we respond to this crisis is a moral test for America. Are we a nation willing to take on an epidemic that is causing great human suffering and economic loss?"